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Mesothelioma Prognosis

A mesothelioma prognosis is generally poor because most patients live about 1 year. The aggressive cancer's latency period does not impact prognosis, but late onset of symptoms delays effective treatment. Early-stage patients live an average of 22.2 months, while late-stage patients live about 14.9 months.

Doctors describe a mesothelioma prognosis as an overall outlook, specific to the patient.

Prognosis is often measured in terms such as “good,” “favorable,” “bad” or “poor” based on how the cancer is expected to progress. It includes the prospect of recovery and helps determine what treatment options may be available.

When patients ask about their prognosis, what they usually want to know is how long they will live.

How Long Do You Live After Being Diagnosed with Mesothelioma?

Most patients live about one year after being diagnosed with mesothelioma.

How long you live with mesothelioma depends on the stage you are diagnosed at and how well you respond to mesothelioma treatments.

People diagnosed early, in stage 1 or stage 2, often qualify for surgery, which offers the best chance at long-term survival. Approximately 20 percent of pleural mesothelioma patients are diagnosed early enough to qualify for surgery. Stage 1 patients who undergo surgery have a median life expectancy of 22.2 months.

Average life expectancy of mesothelioma patients who undergo treatment.

But most patients are diagnosed late, at stage 3 or 4, and do not qualify for surgery. Stage 4 patients who undergo treatment have a median life expectancy of 14.9 months.

Although history and statistics play a part in determining your prognosis, every mesothelioma case is unique.

Some mesothelioma patients are beating the typical outlook thanks to advances in treatment and care. Survivors credit life span increases to multimodal treatment, improvements in their diet and complementary therapies.

Life Expectancy

A person’s life expectancy is affected by their mesothelioma prognosis. The term “life expectancy” refers to the average age a person or population is expected to live based upon their location and other demographics.

Mesothelioma can shorten a person’s life expectancy by several years or decades. It all depends on their age at diagnosis and how long they live with mesothelioma.

For example, a healthy 70-year-old man has a life expectancy of 14 years. If he is diagnosed with stage 4 mesothelioma, his life expectancy is reduced to two years.

Survival Rates

Mesothelioma prognosis is primarily based on the cancer’s average survival rates. This measures how long most people live with mesothelioma.

Survival rate is defined as the percent of people who survive a disease for a specified period of time, usually five years.

The National Cancer Institute says the five-year survival rate for mesothelioma was 9 percent between 2007 and 2013.

Following a diagnosis, it is important to receive a prognosis from a mesothelioma specialist. These doctors are highly trained and experienced in mesothelioma treatment. They can more accurately predict how your diagnosis will affect your life span.

Prognosis by Mesothelioma Type

The four types of mesothelioma affect your body in different ways. The exact type plays an important role in determining whether your prognosis will be good or bad.

Pleural Mesothelioma

The prognosis for patients with pleural mesothelioma — the most common type — is not favorable. Research shows approximately 40 percent of patients survive for one year after diagnosis. Because the cancer forms in the lining of the lungs, tumors put pressure on the chest cavity. This makes it difficult to breath and may lead to pneumonia or congestive heart failure.

Some patients who undergo multimodal treatment and complementary therapies survive several years after diagnosis. About 9 percent of pleural mesothelioma patients survive more than five years.

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Information on mesothelioma treatment, including diagnosis, prognosis and more.

Peritoneal Mesothelioma

Patients with peritoneal mesothelioma have a far better prognosis. New treatments for abdominal cancer, such as heated chemotherapy, have improved the chance of long-term survival. Around 50 percent of patients who undergo surgery with heated chemotherapy live longer than five years.

Pericardial Mesothelioma

Prognosis for pericardial mesothelioma is generally poor. Around half of patients survive six months. Rare cases of five-year survival have been reported and usually involve treatment including surgery and chemotherapy.

Testicular Mesothelioma

Although testicular mesothelioma is the rarest type, its prognosis is typically the best. Average survival is around two years and some patients live more than a decade.

Prognosis by Mesothelioma Stage

The size of tumors and how far they have spread (metastasized) from their original location affect prognosis. Doctors typically discuss tumor size and the extent of a cancer’s spread in terms of stages, ranging from stage 1 to stage 4 in order of severity. Patients with stage 1 or stage 2 (early stages) will typically have a better prognosis than patients with stage 3 or stage 4 (advanced stages).

More prognosis data by stage is available for pleural mesothelioma than peritoneal. The reason for this is twofold. First, the pleural type is significantly more common, meaning there are more patients to gather data on. Second, there is no formally adopted staging system for peritoneal mesothelioma. This prevents researchers from collecting data on peritoneal survival by stage.

Mesothelioma Prognosis at Stage 1

Patients diagnosed at stage 1 have the best prognosis. The cancer does not cause symptoms at this stage. Aggressive treatments are recommended to people in otherwise good health.

Mesothelioma Prognosis at Stage 2

Patients diagnosed at stage 2 have a better prognosis than late-stage patients. The cancer rarely causes symptoms at this stage, but patients may feel short of breath during exercise. Aggressive treatment plans are also recommended at this stage.

The two-year survival rate for pleural mesothelioma is 38 percent and the five-year survival rate is 10 percent.

Mesothelioma Prognosis at Stage 4

The prognosis at stage 4 is generally poor. Symptoms slowly worsen at this stage and patients may develop a fever, night sweats and difficulty swallowing. Palliative treatments are recommended at this stage to control symptoms and extend survival as long as possible.

The two-year survival rate for pleural mesothelioma is 17 percent and the five-year survival rate is less than 1 percent.

Other Factors Affecting Mesothelioma Prognosis

Aside from the type of mesothelioma and its stage, doctors individualize a prognosis based on a variety of factors. Most of these factors are outside of your control, including your age, gender and race.

You can hope to improve your prognosis with the latest treatments and by living a healthy lifestyle.

Gene Hartlinediagnosed with pleural mesothelioma in 2016

“I would tell anyone who gets diagnosed with this disease, don’t just take the first advice you get and give up. Look around and see what is out there.”

Cell Type

The types of cells that make up your tumor — what doctors call histology — can impact your prognosis. Patients with epithelioid mesothelioma generally live longer than those with either sarcomatoid or biphasic (combination) subtypes. Sarcomatoid cells are considered more aggressive and harder to treat. People with epithelioid tumors live an average of 200 days longer.

Age

Your age can affect your prognosis. As we age, our immune system weakens and struggles to fight off cancer growth. Older bodies tend to not respond as well to cancer treatment as younger bodies. For example, older people experience more surgical complications than younger people.

Younger people have a better prognosis with mesothelioma than older people. More than half of patients diagnosed under age 50 live at least a year with mesothelioma. Under a third of patients diagnosed over age 75 live that long.

Gender

Researchers do not fully understand why women live longer. They suspect that hormones may play a role. They do know that women are more often diagnosed with peritoneal mesothelioma. Peritoneal carries a better prognosis than pleural mesothelioma.

Race

Race plays a role in mesothelioma prognosis. In 2013, the five-year survival rate was 8.7 percent for whites and 10 percent for blacks.

Black women tend to live the longest with mesothelioma. In 2013, the five-year survival rate was 13.6 percent for white women and 30.1 percent for black women.

Improving a Mesothelioma Prognosis

You can choose to be proactive and take steps to improve your prognosis. You can’t change important prognostic factors such as your age, mesothelioma type or cancer stage. But, you can improve your overall health. Try treatments to control the cancer. Take good care of yourself when side effects develop or symptoms worsen.

Leading expert for mesothelioma treatment Dr. David Sugarbaker provides insights on things patients should do before surgery.

Treatment Options for Mesothelioma

Mesothelioma is primarily treated with surgery and chemotherapy. Radiation therapy and immunotherapy play a role in multimodal therapy or clinical trials. Most patients are diagnosed too late to qualify for surgery and only undergo chemotherapy.

People diagnosed in stage 1, 2 or 3 may qualify for aggressive surgery. Tumor-removing surgery offers the greatest opportunity for long-term survival. Surgery can involve removal of an entire lung, part of the lung or only the removal of the lining of the lung, known as the pleura.

Many people wonder if a person can live with one lung, and the answer is yes. Surgery is regularly combined with chemotherapy and sometimes radiation therapy or immunotherapy.

Chemotherapy, radiation therapy and immunotherapy are available for patients at all stages.

The chemotherapy response rate is nearly 50 percent. This means about half of mesothelioma patients experience tumor shrinkage or no new tumor growth for a period of time. A 2016 study published in the journal Clinical Epidemiology found that patients receiving chemotherapy lived an average of 12 months, while those who elected no treatment lived an average of four months.

Palliative care aims to control symptoms and improve quality of life. It is also available at any stage.

Patients with peritoneal mesothelioma can improve their prognosis with a combination of surgery and hyperthermic intraperitoneal chemotherapy (HIPEC). It involves adding chemotherapy drugs to a heated saline solution and pumping it directly into the patient’s abdomen. Research shows roughly half of patients who underwent this procedure survived more than five years.

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Survivors Who Surpassed Their Prognosis

Although recurrence is common, people diagnosed with mesothelioma are overcoming their initial prognoses. Whether it’s because of their particular type of mesothelioma, specialized treatments, genetics or simply changing how they live their lives through improved nutrition and exercise, it’s important to keep hope alive.

Some survivors live years or even a decade or more past their initial prognosis.

Chris Gibney

Pleural mesothelioma survivor

Diagnosed in 2005, Chris Gibney far surpassed his pleural mesothelioma diagnosis. In March 2017, he and his wife welcomed a group of exchange students from Germany to their home. Gibney credits his excellent medical team and a family support group for surviving more than a decade past his prognosis.

Beth Mixon

Peritoneal mesothelioma survivor

At the time of Beth Mixon’s peritoneal mesothelioma diagnosis in 2000, the majority of patients lived less than two years after treatment. Despite a grim prognosis, Mixon is still going strong 17 years after an aggressive cytoredutive surgery.

Kasie Coleman

Peritoneal mesothelioma survivor

Diagnosed with peritoneal mesothelioma in 2010, Kasie Coleman underwent several cycles of chemotherapy and HIPEC treatments. Her cancer went into remission in 2012.

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Mesothelioma Remission and Recurrence

A cancer’s prognosis includes the chances of recovery, which is called remission.

Remission involves a measurable tumor size decrease, which can be described as partial or complete.

Remission is partial when the cancer shrinks in size. Partial remission usually involves at least a 50 percent reduction in tumor size.

Remission is complete when the cancer disappears entirely.

Surgery, chemotherapy, radiation therapy and immunotherapy have the potential to send mesothelioma into partial or complete remission. But complete remission is rare with mesothelioma.

Partial remission is more common than complete when it comes to mesothelioma. Patients can live for years in partial remission.

Unfortunately, mesothelioma tends to recur whether partial or complete remission is achieved. When mesothelioma recurs, it usually recurs locally or regionally rather than distantly. Many clinical trials look for patients with a mesothelioma recurrence to test new and innovative therapies.

Clinical Trials

Mesothelioma clinical trials test second-line therapies to control the cancer when it recurs. Many of these trials involve different combinations of chemotherapy drugs. Some trials combine chemotherapy with immunotherapy.

The goal of these trials is to find more ways to keep mesothelioma in control once it returns. Researchers need a wide range of participants. Patients with prior treatment who are now living with an advanced disease are ideal candidates for clinical trials.

Mesothelioma Death Rates

A cancer’s death rate, also called mortality rate, influences how doctors determine a patient’s prognosis. The mortality rate describes how many people die from the cancer.

For example, from 1999-2015, a total of 45,221 people died from malignant mesothelioma. Nearly 80 percent of those deaths occurred among men. About 37 percent of those deaths occurred among people between the ages of 75 and 84.

Karen Selby joined Asbestos.com in 2009. She is a registered nurse with a background in oncology and thoracic surgery and was the regional director of a tissue bank before becoming a Patient Advocate at The Mesothelioma Center. Karen has assisted surgeons with thoracic surgeries such as lung resections, lung transplants, pneumonectomies, pleurectomies and wedge resections. She is also a member of the Academy of Oncology Nurse & Patient Navigators.

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